Fertility doctors are worried they will be under pressure to implant multiple embryos into women who cannot afford ongoing treatment due to new financial safety net caps, a leading IVF specialist says

Having two embryos implanted into the uterus instead of one raises a woman’s chance of having a multiple birth, says IVF Australia chairman Professor Michael Chapman.

As part of Medicare Safety Net restrictions unveiled in Tuesday’s budget, payments for IVF will be capped at different rates for each stage of treatment once a person reaches the safety net threshold for out-of-pocket medical expenses, which is $1,111.60, or $555.70 for those on low incomes.
This could hit women with an extra $1,500 to $2,000 of out-of-pocket costs per IVF cycle.

There are also caps on safety net payments in other areas including obstetrics, varicose vein and cataract surgery.

Under the changes, pregnant women who choose to see a private obstetrician will be out of pocket by $550 unless doctors lower their fees.

“That is why the government is urging women to question their doctors about their fees,” Health Minister Nicola Roxon said.

An average of $4.5 million of taxpayers’ money is paid to the top 10 per cent of IVF specialists each year.

But Prof Chapman said the government, which says it wants to crack down on specialists who charge exorbitant fees, was using the figures for political gain.

“For every doctor that gets money, there are 10 staff members, the scientists, counsellors and nurses, they get funded through the rebate,” he told AAP.

Prof Chapman said he accepted there had been a 40 per cent rise in IVF fees over the past five years but said that it was in line with general medical inflation.

Current Medicare rebates, which work out to about $4,200 per child, go towards employing about 2,000 people in private IVF clinics nationally and investing in research and facilities, Prof Chapman said.

He estimated out-of-pocket costs for patients would rise from $1,600 to between $3,000 and $3,500 when the safety net caps come into effect on July 1, 2010.

It can often take more than one IVF cycle for a woman to fall pregnant.

“Certainly, patients are going to be more out of pocket for IVF than they have been in the past,” Prof Chapman said.

He warned doctors would be under pressure to implant more than one embryo per cycle into women as a result of safety net restrictions, increasing the chance of multiple births.

“Over the last five years in Australia the twin rate has dropped dramatically because we have been able to put one embryo back,” he said.

“But if patients think they won’t be able to afford the next cycle they will put a lot of pressure on the doctor to put two embryos back.”

Ms Roxon said her department would work with medical professionals to restructure the system to better reflect stages in a treatment cycle.www.sbs.com.au